García Callejo F J, Orts Alborch M H, Morant Ventura A, Costa Alcácer I, Velert Vila M M, Blay Galaud L
Servicio de ORL, Hospital Clínico Universitario, Valencia, Spain.
An Esp Pediatr. 2002 Apr;56(4):310-7.
Oxidative stress secondary to infant tonsillar infection produces the expression of local and systemic antioxidants. Its determination seems to be useful as a marker of tonsillar suffering before tonsillectomy but is currently unknown. The aim of this study was to determine the evolution of this parameter in tonsillectomized children during a long-term follow-up.
One hundred thirty-six children underwent tonsillectomy, 46 for tonsillar hypertrophy without infection and 90 for recurrent tonsillitis. Superoxide dismutase (SOD) concentrations were measured before tonsillectomy and at 6, 12, 24 and 36 months post-tonsillectomy.
Infection provoked significantly higher SOD concentrations than tonsillar hypertrophy in tonsillar tissue (223.06 30.46 vs 156.39 54.05 U/l, p < 0.001) and in blood (1124.91 141.73 vs 1007.19 97.03 U/gr Hb, p < 0.001). There was a strong correlation between tonsillar and erythrocyte concentrations. During the 3-year follow-up, SOD concentrations in blood progressively decreased until stabilizing in all patients. Stabilization was reached at 6 months post-tonsillectomy in the group with tonsillar hypertrophy and at 2 years in the group with infection. Children with recurrent tonsillitis consistently showed higher SOD concentrations in blood throughout the follow-up.
Oxidative damage in tonsillar tissue results from the incidence and severity of focal infections. Tonsillectomy reduces SOD levels but, as a consequence of oxidative stress, these do not return to normal.
婴儿扁桃体感染继发的氧化应激会促使局部和全身抗氧化剂的表达。其测定似乎可作为扁桃体切除术前扁桃体病变的标志物,但目前尚不清楚。本研究的目的是在长期随访中确定扁桃体切除儿童该参数的变化情况。
136名儿童接受了扁桃体切除术,其中46名因扁桃体肥大但无感染,90名因复发性扁桃体炎。在扁桃体切除术前以及术后6个月、12个月、24个月和36个月测量超氧化物歧化酶(SOD)浓度。
在扁桃体组织中(223.06±30.46 vs 156.39±54.05 U/l,p<0.001)以及血液中(1124.91±141.73 vs 1007.19±97.03 U/gr Hb,p<0.001),感染引起的SOD浓度显著高于扁桃体肥大。扁桃体和红细胞中的浓度之间存在很强的相关性。在3年的随访期间,所有患者血液中的SOD浓度逐渐下降直至稳定。扁桃体肥大组在扁桃体切除术后6个月达到稳定状态,感染组在2年时达到稳定状态。在整个随访过程中,复发性扁桃体炎患儿血液中的SOD浓度始终较高。
扁桃体组织中的氧化损伤源于局灶性感染的发生率和严重程度。扁桃体切除术会降低SOD水平,但由于氧化应激,这些水平不会恢复正常。